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Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center.

Publication ,  Journal Article
Bergen, MA; Ryan, SP; Hong, CS; Plate, JF; Bolognesi, MP; Seyler, TM
Published in: Orthopedics
2021

High complication rates associated with revision total knee arthroplasty (TKA) and total hip arthroplasty (THA) may unequally burden tertiary referral centers, which manage medically complex patients. The authors aimed to quantify TKA and THA referral patterns at a tertiary referral center based on travel distance and patient comorbidities. All patients who underwent primary or revision TKA or THA at the investigating institution from 2012 to 2016 were identified. Travel distance was calculated using each patient's home address and stratified into less than 25 miles, 25 to 74 miles, and 75 miles or more. Age, body mass index, Charlson Comorbidity Index, and postoperative clinical data were identified. Patients were analyzed based on procedure performed and travel distance. A total of 4245 procedures were included for analysis (1754 primary TKAs, 432 revision TKAs, 1503 primary THAs, and 556 revision THAs). Patients living 75 miles or more away had significantly higher odds of undergoing revision arthroplasty compared with patients living within 25 miles (knee: odds ratio [OR], 2.43; hip: OR, 2.61; P<.001). Charlson Comorbidity Index did not increase with travel distance. Patients traveling 75 miles or more were more likely to have periprosthetic fracture (OR, 3.91; P=.011) and less likely to have dislocation (OR, 0.54; P=.026) as the surgical indication for revision. Patients referred to a tertiary center were more likely to necessitate revision total joint arthroplasty but did not differ in comorbidity profile compared with local patients. Periprosthetic fracture, a particularly high-risk surgical indication, was overrepresented among referral patients. These data suggest that factors such as underlying diagnosis, but not preoperative medical comorbidities, may influence referral patterns. [Orthopedics. 2021;44(4):e477-e481.].

Duke Scholars

Published In

Orthopedics

DOI

EISSN

1938-2367

Publication Date

2021

Volume

44

Issue

4

Start / End Page

e477 / e481

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Periprosthetic Fractures
  • Orthopedics
  • Humans
  • Arthroplasty, Replacement, Knee
  • Arthroplasty, Replacement, Hip
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bergen, M. A., Ryan, S. P., Hong, C. S., Plate, J. F., Bolognesi, M. P., & Seyler, T. M. (2021). Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center. Orthopedics, 44(4), e477–e481. https://doi.org/10.3928/01477447-20210618-03
Bergen, Michael A., Sean P. Ryan, Cierra S. Hong, Johannes F. Plate, Michael P. Bolognesi, and Thorsten M. Seyler. “Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center.Orthopedics 44, no. 4 (2021): e477–81. https://doi.org/10.3928/01477447-20210618-03.
Bergen MA, Ryan SP, Hong CS, Plate JF, Bolognesi MP, Seyler TM. Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center. Orthopedics. 2021;44(4):e477–81.
Bergen, Michael A., et al. “Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center.Orthopedics, vol. 44, no. 4, 2021, pp. e477–81. Pubmed, doi:10.3928/01477447-20210618-03.
Bergen MA, Ryan SP, Hong CS, Plate JF, Bolognesi MP, Seyler TM. Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center. Orthopedics. 2021;44(4):e477–e481.

Published In

Orthopedics

DOI

EISSN

1938-2367

Publication Date

2021

Volume

44

Issue

4

Start / End Page

e477 / e481

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Periprosthetic Fractures
  • Orthopedics
  • Humans
  • Arthroplasty, Replacement, Knee
  • Arthroplasty, Replacement, Hip
  • 3202 Clinical sciences